Children with behavioral difficulties present with elevated frequency to primary care. Triple P is designed to reduce visit length by offering 5 levels of intervention intensity, 3 of which can be carried out during well visits, including group well visits. Higher levels add social work and mental health services and are conducted apart from well visits. Triple P has well-constructed and tested materials, and abundant evidence of positive changes in parenting skills. The site includes key findings and references for >200 studies.

Used in educational and health care settings, the program’s goals are to prevent conduct problems, promote social competence, intervene in problematic parenting, reduce symptoms of attention-deficit/hyperactivity disorder, and build school readiness skills. Studies on IY are extensive and the site houses videos, research findings, and teaching materials.

One of the largest nationwide parenting education organizations, PAT offers parents of young children access to monthly home visits and group visits conducted by trained parent educators who provide guidance on child development and ways to encourage learning. Research (listed on the Web site) indicates particular effectiveness with low-income, American-Indian, and Spanish-speaking families.

STEP offers training for parent educators in use of its 9-week group education program and relies on well-written, easy-to-read books along with multimedia approaches. There are unique versions focused on teenagers, early youth, Christian families (Bible STEP), and Spanish-speakers (Next STEP). Leadership training covers discrete issues such as “Understanding Yourself and Your Child,” “Understanding Beliefs and Feelings,” “Encouraging Your Child and Yourself,” “Listening and Talking to Your Child,” and “Helping Children Learn to Cooperate, Discipline that Makes Sense.” Research on STEP is reasonably extensive and shows program effectiveness particularly with middle- and upper-income families.

One of the largest national and international self-help organizations, PA is designed to break the cycle of child abuse by providing “safe, supportive weekly meetings where parents under stress can discuss their problems with their peers and with trained volunteer professionals.” PA groups are cofacilitated by volunteer human service professionals called “sponsors,” along with a parent member or chairperson for each group. After joining, members receive a handbook explaining the goals of PA, its basic guidelines for operation, information about anger management, a needs assessment, and a list of other members’ telephone numbers. The site includes research findings on effectiveness in reducing physical and verbal abuse.

Home visiting programs

Home visiting programs have proven effectiveness especially when using evidence-based curricula aimed at a targeted group (eg, low-income adolescent mothers). Because these initiatives are rare (at least in the United States), we provide links to 2 programs worth exploring for local availability: www.strengtheningfamilies.org and www.parentsasteachers.org.